Longitudinal Knowledge Assessment

[LoudBark]

Anyone done the new ABIM Longitudinal Knowledge Assessment for your IM or subspecialty recertification?
So choice is between a 10 year test and the cramming material that you probably never or seldom see on a daily basis and studying for months before.......vs doing 30 questions every 3 months for an eternity.

So has anyone considered which route to go for recertification or have experience with the Longitudinal Knowledge Assessment or have thoughts on it?

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[rokshana]

Anyone done the new ABIM Longitudinal Knowledge Assessment for your IM or subspecialty recertification?
So choice is between a 10 year test and the cramming material that you probably never or seldom see on a daily basis and studying for months before.......vs doing 30 questions every 3 months for an eternity.

So has anyone considered which route to go for recertification or have experience with the Longitudinal Knowledge Assessment or have thoughts on it?

Doing LKA…it’s great! Open book and takes maybe 2 hours every quarter…way better than having to sit at some testing center for the whole day.

 

[LoudBark]

Doing LKA…it’s great! Open book and takes maybe 2 hours every quarter…way better than having to sit at some testing center for the whole day.

Thank you. So with 4 minutes a question, you think that gives you enough time?
Also, how is that thing scored? You have to get a certain number of correct questions every 5 years to remain certified? Do you know how many you need correct?

 

[rokshana]

Thank you. So with 4 minutes a question, you think that gives you enough time?
Also, how is that thing scored? You have to get a certain number of correct questions every 5 years to remain certified? Do you know how many you need correct?

4 mins is plenty of time and you get a bank of time that you can use to increase in 30 sec intervals if you want it.
They haven’t said yet. I’ve done it for a year.

 

[DrMetal]

Anyone done the new ABIM Longitudinal Knowledge Assessment for your IM or subspecialty recertification?
So choice is between a 10 year test and the cramming material that you probably never or seldom see on a daily basis and studying for months before.......vs doing 30 questions every 3 months for an eternity.

So has anyone considered which route to go for recertification or have experience with the Longitudinal Knowledge Assessment or have thoughts on it?

I'm opting for the 10 year option, b/c I don't want the ABIM encroaching on my mental space every 3 months.

I'm also hoping that by the time I have to re-certify, maybe we will have come to our senses and abolished this fascist requirement and the organization (the ABIM) that mandates it. There's a drum beat now, with organizations like NBPAS gaining some traction, hopefully it happens.

 

[gutonc]

I can see reasonable arguments for both. I'm also one of those people who feels that board certification is a reasonable thing to expect and aspire to.

On one hand, a couple of hours in your PJs on the couch 4x a year seems alright, on the other, my initial onc board cert exam only took me 5 hours to complete (out of four 2 hour blocs) and I got to forget about it for an entire decade. I can't speak to any other specialty, but the onc recert exam is 25% shorter than the initial cert, so I anticipate wrapping it up in 3-4h at the most.

I've got another year before I have to make the call on this and, unless they get the LKA down to 30 questions a year or under an hour of time invested, I'll probably stick with the big exam.

Thank you. So with 4 minutes a question, you think that gives you enough time?

4 minutes? Assuming no learning disability that gets you extra time as it is, if you're taking more than 30-45s a question on average, you're really doing it wrong.

 

[LoudBark]

I can see reasonable arguments for both. I'm also one of those people who feels that board certification is a reasonable thing to expect and aspire to.

On one hand, a couple of hours in your PJs on the couch 4x a year seems alright, on the other, my initial onc board cert exam only took me 5 hours to complete (out of four 2 hour blocs) and I got to forget about it for an entire decade. I can't speak to any other specialty, but the onc recert exam is 25% shorter than the initial cert, so I anticipate wrapping it up in 3-4h at the most.

I've got another year before I have to make the call on this and, unless they get the LKA down to 30 questions a year or under an hour of time invested, I'll probably stick with the big exam.

4 minutes? Assuming no learning disability that gets you extra time as it is, if you're taking more than 30-45s a question on average, you're really doing it wrong.

30-45 sec a question is for a whiz who never needs to use outside sources. Yes there are plenty who may be like that......and great for them if they are. But for us mere mortals who can not recall some obscure disease we never see in real life practice (but some bozo in the ABIM question writing committee still thinks it is of utmost importance for me to maintain my boards in my specialty) and need to go to Up To Date or whatever, it may push the 4 min mark. And no I am not saying every single question will be like that. Hopefully there will be quite a few that we can all nail in the 30-45 sec because we immediately know the answer.

 

[DrMetal]

I can see reasonable arguments for both. I'm also one of those people who feels that board certification is a reasonable thing to expect and aspire to.

Sure, once, initially after you finish residency and fellowships.

After that, a physician should aspire to (and be judged on) doing a good job in taking care of her patients, period. (not on the merits of some q3 month or q10year multiple choice test that chatGPT could pass)

 

[gutonc]

Sure, once, initially after you finish residency and fellowships.

After that, a physician should aspire to (and be judged on) doing a good job in taking care of her patients, period. (not on the merits of some q3 month or q10year multiple choice test that chatGPT could pass)

I have seen some completely bonkers s*** from physicians who are grandfathered in to the pre-MOC system. I definitely think a system to keep up and evaluate the knowledge base on an ongoing basis is needed. I won't argue that ABIM is the best one possible. But there are definitely some worse ones.

 

[dozitgetchahi]

I have seen some completely bonkers s*** from physicians who are grandfathered in to the pre-MOC system. I definitely think a system to keep up and evaluate the knowledge base on an ongoing basis is needed. I won't argue that ABIM is the best one possible. But there are definitely some worse ones.

I hate the ABIM but I agree with you wrt knowledge maintenance…hell out here in semi-rural flyover country where I work, I regularly see completely bonkers **** from not just old grandfathered dinosaur docs but also relatively young board certified folks who should really know better. It’s been bad enough that I do think some sort of movement towards regular exams is probably on the horizon one way or another (sadly). Turns out that not all docs take CME seriously, and some seem to suck straight out of training - and once you’re out of training, nobody is actually watching you that closely unless you do something flagrantly stupid enough to draw the attention of the medical boards etc. (And it turns out that’s actually pretty hard to do. Seems a doc can do a lot of bonkers **** for a long time and basically nobody will care that much, as long as he/she doesn’t leave a trail of dead/maimed patients behind them.)

 

[FutureInternist]

UpToDate on one tab.
Google on other 😏.
Plus some of my own neurons.
I DO pick an answer & then use above to “check” cos o/w there really is NO point

Pretty easy to do the LKA, specially since you never know how the day of the exam goes…. Could be sick, not enough sleep etc.

Compared to the initial cert I took, these Qs are waaaayyyy easier… not sure if that is true for the 10 year recert exam

 

[FutureInternist]

…doing a good job in taking care of her patients, period. (not on the merits of some q3 month or q10year multiple choice test that chatGPT could pass)

That changes though…
Coumadin vs DOAC
Activated protein C vs NOT (pulled off market b/w my intern and 3rd year)
PPI gtt vs BID vs no need at all
IV vs PO antibx for osteo-

Lots of things change or are up for debate & the only way to keep up is to read the organisation’s material…. Maybe some would read even if there was no exam but I would venture most need that push to read up.

 

[VA Hopeful Dr]

UpToDate on one tab.
Google on other 😏.
Plus some of my own neurons.
I DO pick an answer & then use above to “check” cos o/w there really is NO point

Pretty easy to do the LKA, specially since you never know how the day of the exam goes…. Could be sick, not enough sleep etc.

Compared to the initial cert I took, these Qs are waaaayyyy easier… not sure if that is true for the 10 year recert exam

I'm doing the FM version of this and that's the exact same approach I'm using.

 

[DrMetal]

That changes though…
Coumadin vs DOAC
Activated protein C vs NOT (pulled off market b/w my intern and 3rd year)
PPI gtt vs BID vs no need at all
IV vs PO antibx for osteo-

Lots of things change or are up for debate & the only way to keep up is to read the organisation’s material…. Maybe some would read even if there was no exam but I would venture most need that push to read up.

Cmon, we've been through this before. Does a CPA have to take a test every year in lieu of new tax codes? Does the lawyer have to re-bar every 10 years in lieu of changes in the law? No. But you dam well bet each does his own CE and keeps up with such changes, lest they want to lose their clients or go to jail.

Doctors should be no different. You want to continue practicing? Do good CME, keep current and stay engaged. Period, No test necessary.

I have no doubt that there are 'bonkers' physicians out there. But guess what, MOC/BC is not going to fix that. Said bonkers physicians will do the MOC/BC as prescribed (they'll take the test, answer every question exactly how you want them to), then they'll go right back to being 'bonkers'.

The answer to this is not more MOC/BC. The answer to this is a) better surveillance programs to catch the 'bonkers' , then b) disciplinary measures to straighten them out or remove them from practice. This is all best done by your home credentialing institution, not some BS 'nonprofit' (the ABIM) from a small office in Philly.

 

[sloh]

Cmon, we've been through this before. Does a CPA have to take a test every year in lieu of new tax codes? Does the lawyer have to re-bar every 10 years in lieu of changes in the law? No. But you dam well bet each does his own CE and keeps up with such changes, lest they want to lose their clients or go to jail.

Doctors should be no different. You want to continue practicing? Do good CME, keep current and stay engaged. Period, No test necessary.

I have no doubt that there are 'bonkers' physicians out there. But guess what, MOC/BC is not going to fix that. Said bonkers physicians will do the MOC/BC as prescribed (they'll take the test, answer every question exactly how you want them to), then they'll go right back to being 'bonkers'.

The answer to this is not more MOC/BC. The answer to this is a) better surveillance programs to catch the 'bonkers' , then b) disciplinary measures to straighten them out or remove them from practice. This is all best done by your home credentialing institution, not some BS 'nonprofit' (the ABIM) from a small office in Philly.

This is so true. It's a very different mindset and emotional resonance between studying for an exam and studying because you actually want to be competent. It's hard to explain but those of you who practice good medicine and know you're above average know exactly what I'm talking about.

 

[VA Hopeful Dr]

Cmon, we've been through this before. Does a CPA have to take a test every year in lieu of new tax codes? Does the lawyer have to re-bar every 10 years in lieu of changes in the law? No. But you dam well bet each does his own CE and keeps up with such changes, lest they want to lose their clients or go to jail.

Doctors should be no different. You want to continue practicing? Do good CME, keep current and stay engaged. Period, No test necessary.

I have no doubt that there are 'bonkers' physicians out there. But guess what, MOC/BC is not going to fix that. Said bonkers physicians will do the MOC/BC as prescribed (they'll take the test, answer every question exactly how you want them to), then they'll go right back to being 'bonkers'.

The answer to this is not more MOC/BC. The answer to this is a) better surveillance programs to catch the 'bonkers' , then b) disciplinary measures to straighten them out or remove them from practice. This is all best done by your home credentialing institution, not some BS 'nonprofit' (the ABIM) from a small office in Philly.

Not exactly a great comparison. People can easily get new CPAs/lawyers. Much of medicine doesn't allow that. Its very difficult to get a new ED doctor or hospitalist during a visit and you can't usually request a certain one on admission.

Many places only have 1 of certain specialties and many of those don't allow doctor switching within the practice. Want a new derm? Cool, that'll be 6 months from now.

Beyond that, MOC doesn't have to be that bad. ABIM has screwed up royally the last 10 years or so I get the frustration. ABFM does good work, I learn a fair bit every time I do one of the required yearly activities (except the quality stuff, but there's no escaping that anytime soon).

 

[dgdg]

Anyone done the new ABIM Longitudinal Knowledge Assessment for your IM or subspecialty recertification?
So choice is between a 10 year test and the cramming material that you probably never or seldom see on a daily basis and studying for months before.......vs doing 30 questions every 3 months for an eternity.

So has anyone considered which route to go for recertification or have experience with the Longitudinal Knowledge Assessment or have thoughts on it?

I did the 10 year moc exam again. Frankly I couldn't stand the thought of being tied down quarterly to the question quota (4 min vs 2 min/question is not much a difference) finding out if I passed after 5 years in. For me it was one and done. It's most of one day, no biggie. YMMV.
The moc 10 yr exam pass rate is quite high. If you practice using UpToDate with the question banks, you'll have a good feel for the timing and what's worth looking up.

 

[dozitgetchahi]

Cmon, we've been through this before. Does a CPA have to take a test every year in lieu of new tax codes? Does the lawyer have to re-bar every 10 years in lieu of changes in the law? No. But you dam well bet each does his own CE and keeps up with such changes, lest they want to lose their clients or go to jail.

Doctors should be no different. You want to continue practicing? Do good CME, keep current and stay engaged. Period, No test necessary.

I have no doubt that there are 'bonkers' physicians out there. But guess what, MOC/BC is not going to fix that. Said bonkers physicians will do the MOC/BC as prescribed (they'll take the test, answer every question exactly how you want them to), then they'll go right back to being 'bonkers'.

The answer to this is not more MOC/BC. The answer to this is a) better surveillance programs to catch the 'bonkers' , then b) disciplinary measures to straighten them out or remove them from practice. This is all best done by your home credentialing institution, not some BS 'nonprofit' (the ABIM) from a small office in Philly.

Yeah, I agree.

Most “bonkers” docs I’ve encountered are board certified, so clearly it doesn’t do much to prevent this.

 

[pishicat]

I have to recertify for the second time last recert 2014- getting too old for this nonesense. . Am I missing something? If you have to pay $120 every year now anyway. Wouldn’t it make sense to just sign up for the LKA, and then just look like you’re certified for the next five years and then if the pass/fail option comes and you failed then you sit for the full One day exam. It seems like you have nothing to lose by signing up for the LKA assessment. Right? Unless if you sign up for it, you cannot back out of it and change your mind and take the full one day exam? I would think by signing up for the LKA you would also start getting practice on answering questions. I’m just saying since it’s FREE , and you have to pay the $120 fee anyway. Can someone explain this to me?
also,

I work for the government, and I don’t have to work in a hospital and i work in an occ med setting . So I have no idea if it’s even required for me to maintain my ABIM certification. I don’t want to ask, because I will shine light on myself - lol. I’m assuming you just have to have a valid license, I don’t think anybody goes back and looked at your ABIM certification.

 

[kaycee18]

I am confused as to the start dates. Do I start the LKA on the 10th year after my certification? for example, got certified in 2021. Do I start the LKA on 2031? Or do I start it in 2022?

 

[gutonc]

I am confused as to the start dates. Do I start the LKA on the 10th year after my certification? for example, got certified in 2021. Do I start the LKA on 2031? Or do I start it in 2022?

You need to start MOC as soon as you get certified. You don't do LKA until your original certification is lapsing and you decide to do that vs the 10y recert.

 

[HemeOncHopeful19]

Why am I paying a yearly tax for something that I don’t have to start doing for 10 years 🤔

 

[LoudBark]

Why am I paying a yearly tax for something that I don’t have to start doing for 10 years 🤔

The short answer, legal extortion. Pay up......or we drop your board certification.

 

[mooshka]

I did the 10 year moc exam again. Frankly I couldn't stand the thought of being tied down quarterly to the question quota (4 min vs 2 min/question is not much a difference) finding out if I passed after 5 years in. For me it was one and done. It's most of one day, no biggie. YMMV.
The moc 10 yr exam pass rate is quite high. If you practice using UpToDate with the question banks, you'll have a good feel for the timing and what's worth looking up.

Hi. Thanks for the post. After taking the exam just wondering which study materials that you feel would be best to use for the recertification exam. I was thinking to use a primary care ambulatory medicine study book, supplement Harrison’s and may be a question bank? What do you think

 

[dgdg]

Hi. Thanks for the post. After taking the exam just wondering which study materials that you feel would be best to use for the recertification exam. I was thinking to use a primary care ambulatory medicine study book, supplement Harrison’s and may be a question bank? What do you think

There is a large thread on the big one and done ABIM exam. You'll find everything you need there.
(Study book is going to be very low yield - advise against it.)